Sunday, September 21, 2008

The Tyranny of Diagnosis

Not long ago, while surfing online for one disease, I got sidetracked by another: cryptogenic cirrhosis.

I have cared for patients with cryptogenic cirrhosis. It is a common cause of liver-related illness and death in the United States, and symptoms can range from jaundice, bleeding and confusion to life-threatening hemorrhage, coma and death.

The cause of the disease, as the name implies (from the Greek “krypt,” or hidden, and “genesis,” or origin), has long been unknown. Every one of my patients with cryptogenic cirrhosis has heard the same thing from their doctors, including myself: “We have no idea why you are so sick.”

For these patients, cryptogenic cirrhosis is not a diagnosis but a non-diagnosis.